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ect red campaign. our coverage begins at 6:00 p.m. eastern. coming up next here on c-span, "q&a" with documentary film producer and director matthew heiniman followed by deputy british prime minister and this year's veterans' day ceremony at arlington national cemetery [captioning performed by national captioning institute] [captions copyright national cable satellite corp. 2012] >> this week on q&a, film maker matthew hineman discusses his documentary, escape fire. currently available in select theaters, i tunes and video on demand. >> one of the things on your biosheet that i noticed is that
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you developed a multimedia undertaking called the young americans project in the last few years. what was it? >> the film project called our time. i actually studied history in college. i actually wanted to be a teacher and i got rejected from teach america and sort of was sitting around with my college friends trying to decide what to do and we hatched up this plan to drive across the country interviewing kids from all walks of life. we got sponsorship money, got an rv and ended up driving around the country. and that was my first film. i learned a ton about film making and life and fell in love with the process. we had a blog, shot a film, tried to write a book.
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nothing came out of the book. but from that film it led me to a job at hbo. and sort of started me down this crazy path of making documentary films. >> one quick question about teach for america. how big an ego distorter is that when they don't pick you? how many young people try to become at teach for america? >> i couldn't believe it. i'm trying to help people and be a teacher and i didn't know you could get rejected. it hurt my ego but i think i wouldn't be sitting here if that hadn't happened. and i ended up interviewing wendy cop, the founder of teach for america. >> go back to the whole process of going across the country. where did you go? what year? what people were with you and what did it cost you? >> we did it in the fall of 2005. i did it with three of my best friends. and it was really cheap.
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we were scrapping together money from family and friends. we got sponsorship money from corporations. but it was really boot straps. you know, rough film making. i had never held a camera before or taken a class before. it was really an exhilarating experience. what an honor to go up to anyone across the country and get their story and speak to them about truths and depths of their lives. it was really a meaningful experience. it was wonderful because we had sort of a wide range of characters from -- half the interviews were planned from mark zuckerburg to a drug dealer on the street to a cancer researcher to a homeless kid. so it was really a ca lied scopic adventure. >> what did you learn about
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young people? >> i learned a lot. i mean, i learned that i think no matter where -- it's sort of cliche but no matter where you're from, no matter what your background is, everyone had this burning desire to be better to do better, to improve their strength and to improve themselves. and i sort of walked away from that trip -- we sort of went into that trip with all these preconceived notions that people and other generations were calling us directionless. and i walked away feeling inspired. that our generation does want to fix this country, does want to fix this world. and i don't know if it's going to happen overnight. i think our world is changing every day and i think the way we communicate, the way we effect change is going to be different than my father and my mother who grew up in the 60's.
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we're not out there in the streets protesting. i think we communicate and spread information in a much different way. >> so where did you grow up? >> i grew up -- i was born in d.c. i grew up in connecticut, went to school in new hampshire. >> what was the atmosphere of your family? what did your parents do? >> my mother was a journalist actually. she was a science writer. she wrote for the "washington post." >> was -- >> christine russell. she kept her maiden name. my dad is a lawyer. he started in the public sector. and then ended his career for 20 years working for general electric. and now teaches up in boston. >> this is the well-known ben hineman. wasn't his father also well known? >> yes. >> explain that. actually this is the first i've learned this from you.
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but how do they fit into the past? >> i had a very -- my parents and my grandparents are amazing people. i feel very lucky. >> what did they do? >> my grandfather was a self-made man. his father actually killed himself in 1929 after the stock market crashed and he was left sort of alone to fend for his family. he went to school, climbed his way into law school, and started out as a lawyer and then ended up running northwest railroad and a number of other businesses in chicago. and was very civic minded, too. he was an advise tor president johnson and others. i think my dad and i have sort of inherited a lot of his social beliefs.
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and i think i carry a lot of that into the film making that i do. >> why did you decide to study history? >> i didn't know what else to study. i really didn't know what i wanted to do with my life. i didn't have a lot of direction. i played sports in college. i always had been fascinated by history, by the civil war, took a trip in high school to getiesburg and loved history so i decided to major in it. i think it taught me to be analytical, to think critically about events. i really tried to learn from the past to affect the future. >> why film though? what did you think film would do for you? actually -- did you do film or did you do tape? >> tape. video. >> but why video? >> again, i think i sort of stumbled into it. i sort of fell in love with the process.
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and i think film has just an amazing power to really tell stories in a way that touches audiences and touches people viscerally in a way that the written form can't do. i mean, you can really speak great social truths through the power of the documentary forum. and it's such a mallable forum. in this film that i'm sure we'll talk about, we shot scenes, we had talking head interviews, we lit a hill on fire, we had animation. it was really a hybrid forum with all these different techniques that we used to really tell a story of our broken health care system. so it's a beautiful forum and i love documentaries. >> we'll get to it in just a second. but go back to that first
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documentary you did. or was it a documentary when you did the travel across the country? >> we thought we were going to make a documentary. and we shot 150 hours of footage. but we didn't -- again, we didn't know what we were doing. we were just filming and meeting people and following our gut and sort of came home three months later and we said what the heck are we going to do with this? and bought final cut pro which is a cheap editing program and bought some books and played around with the footage. we were actually in new orleans three months after catrina so i made a short about that day that we were there. and again, i just -- i kind of was amazed at how -- about this forum. about how moving it was to do this. i just fell in love with the process. >> so you've got this video somewhere that you haven't
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really used in a kind of long form. >> then we submitted a bunch of film festivals, got reject bid a bunch of film festivals. kept getting rejected and kept getting teased by people. people kept saying this is really brilliant but i'm not sure if it fits for us. eventually i got in the hands of an executive at hbo and he brought me in, he said i love the film. we love the film here. we don't want to buy it. but we want to hire you to help produce the alzheimer's' project which is a big public health campaign that they were doing. so i was hired as one of their producers. >> so you still have all that video. >> and then i continued to edit the film. and eventually sold it to the documentary channel. it's now available on amazon and hullu and other digital platforms. >> and the name? >> our time. >> make the transition into the
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alzheimer's' project. how did that go? when did it go? i know on my home set it's still there on demand, inl. rfmentor i think you can still watch it on demand. >> but you can also buy it. >> i think you can stream it on line still. again, i submitted my film our time which my first film our time and i got hired ended up getting hired as a producer to work on the alzheimer's prozz ject. >> why did hbo want to do this project? >> i think it's -- they're a wonderful channel. they produce a ton of content but they're really socially conscious and every couple years they produce large public health campaigns. first, there's one on cancer. then addiction. you know, i worked on the alzheimer's' project. and then they most recently did
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a big public health campaign on obesity. >> what did you learn? what were the big things you learned from the alzheimer's' project and how many shows were there? >> there were four different films. and i was a producer on one of them. on momentum and science, which is where we are in the science of alzheimer's'. there's a film for children. there's a film for care givers. and i mean, i learned a ton. i had gone from working on my own in a closet in my apartment editing my first film to working with oscar nominated emmy award winning film makers who became my mentors. john hoffman who is the executive and producer of the project who hired me has really been a mentor. i worked -- he's a wonderful man who has been very kind to
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me throughout my career. i also collaborated with susan fonchingy intimately and we got along really well and decided to work on our latest film together. >> what is susan from can i? >> an oscar nominated film maker. her first film was gray gardens. and she's made over 30 films in her career. so it's really been a privilege. it was a prilidge working there at hbo with such talent. and it was sort of my film school. >> so how close are you to your 30th birthday? >> i'm a year away. >> so you've done all this and you're 29. >> yeah. >> the reason we ask you here besides all this background is because you have a documentary that's just been released within the last month or so about what? >> so the film that's called escape fire, the fight to
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rescue american health care. and it's about how and why our system is broken why it doesn't want to change. and really people out there who are trying to change it. we started making the film in 2009 just as the health care debate was heating up. and there was -- there's so much fear and confusion around the topic. it was dividing our country. the topic of health care. and i think both susan and i really wanted to try to understand how the system came to be. why did this per verse system exist? but we also want to find solutions and people out there who are trying to change it. so we didn't want to make it just -- we wanted to make a film that highlighted solutions as well. >> let's jump into a cut. we have about 10 minutes of your hour and 39 minute documentary that we're going to run during this discussion. let's jump in and you can tell us who the people are that we're seeing.
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>> sure. >> ok. i need some help over here. >> tried to get up? >> he's trying -- he just rolled himself out. he's like really not listening very well. that's why you don't want him to fall again. i'm going to check his chart real quick to find out what he got. >> where are you? >> we are on a medivac flight
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from ram stine, germany, to andrews air force base. and we were really looking at the military as a microcosm for the rest of america in that they have this sort of default reliance on pharmaceutical drugs. and in america we spend $300 billion a year on drugs and that's almost as much as the rest of the world combined. so we really wanted to try to explore this and we ended up deciding to explore it through the military. you can almost not pick up the paper every day and not see something about overmedication or suicide in the military. and so when we heard that the military was actually trying to fix this problem that they were trying to do a study to try to see if acupuncture could work in lieu of drugs on this flight, we -- it just was sort of a home run story that we wanted to explore.
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and it took us about a year to get access to get on that plane. and we had to get permission from the u.s. air force, the u.s. army. and it took a long long time. two weeks before getting on that plane, we didn't have permission and i was sweating bullets as right before new year in 2010. and finally at the last minute we got permission to get on that plane. what we see there is -- we don't see one of the people who are in that study. we actually ended up following a character named sergeant yates who was heavily heavily overmedicated. and what we see in that clip is really sort of what happens when we have a fragmented system. when we have a bunch of different doctors picking up different pieces of us but not looking out for the whole person. there's no way that a human
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being should be on that many drugs. he almost died of a plane. >> he holds up containers of pills. >> and the nurses and doctors couldn't figure out he was on, how many drugs he was on. and his blood pressure dropped to a really dangerous level where he almost died. the whole plane was really on shutdown. everyone was on like high alert. >> that was in the air? >> we were in the air across the atlantic. >> you came from ram stine germany? >> to andrews air force base. and sergeant yates, the young man who we see in that clip, really ended up being sort of the heart and soul of the -- our film. somebody that we ended up following for about six months. >> did he agree before or after that you could use this? >> he agreed before. >> did he sign something? >> yes. >> so the whole trip you were allowed to shoot whatever happens to him?
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>> yes. we basically got free rein to film anything with the military. you know, obviously within reason. but for patients that we were following intimately, we needed to get a release from them and the military knew to get a release from them as well. so he signed something before we got on the plane. >> did the military have any say as to what you could use? >> no. >> how many people were with you on the plane? >> we had a very small crew. the way we work is really intimately. so as unobtrucive as possible. it was just myself, my cinema ing to fer and my soundman and i was filming a little bit as well. i think the key to that scene is that none of that would have worked -- in many ways i think that's sort of the emotional crux of the film. it's where we really sort of get into the belly of the beast
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of our system and see sort of -- it's one of the most raw moments of our film. and none of it would have happened if we hadn't have been able to plug into the nurses' head sets to be able to understand what's happening because it's so noisy in there you couldn't even hear yourself think or talk. >> where is sergeant robert yates today? >> so we ended up following him after this plane ride for many months, as i said, and he ended up entering himself into an innovative program at walter reed where they ended up using acupuncture, using meditation, using other techniques to wean him off of all the drugs that he was on. and there through this program he actually was able to walk out of walter reed on his own two feet. so i really commend the military for two things. for one, for allowing us to tell this story both the good and the bad. but for recognizing this
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problem. by recognizing that there is this problem of overmedication and that they are looking for outside the block ideas on how to fix it. that's sort of the whole thesis of the film, really. the metaphor of escape fire is that the status quo isn't working and we need to start looking for outside the box ideas. >> explain because we haven't seen it what is escape fire? >> the short version or long version? >> so people have an idea why the name. >> so escape fire is a metaphor that dr. done bur wick draws for us between our health care system and a forest fire that happened in 1949. and basically what happened was these forest firefighters were dropped in to fight this fire. filled with the latest and greatest technology. and through this hubris they called it a 10:00 fire. to be beat by 10:00 the next
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morning. suddenly the wind shifted direction and they found themselves running up this hill for dear life and the leader of this group lit a match, he burned the area around him so when the fire came and overtook him he would be safe in whatsdz now know what's now known as an escape fire. and he called for his men to join him and nobody did and they all kept running up the hill. they all died and he remained unharmed. and it's really this metaphor that our health care system is burning and we're all running up the hill sticking to the status quo where the answer is right here in front of us. >> here's another couple of people that we see a lot of in the documentary. the journalist -- former journalist sharon and dr. leslie chow. sharon bedroomly was -- shannon excuse me, was with u.s. news at one point. why did you pick her?
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>> she had written a book called overtreated. and that book was sort of seminal for us in understanding that this -- that more is not better when it comes to health care. that more can actually hurt us. and it was her book that really explained that to us and therefore i sought her out to be in our film. >> here she is and others. >> the vast majority of doctors in this country are paid by a fee for service system. and that simply means that they get paid for each office visit. if they're surgeons they get paid for each procedure. if it's a radiologist, they get paid for each ct scan that they deliver. >> if i spend 5 minutes with you and then put in one of these stints, i probably get paid $1500. for me to spend 45 minutes on an established visit with a patient to make sure they're
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doing their exercise, and to try to figure out what their true problem is, i probably get paid $15. it's a completely irrational system. >> fee for service rewards physicians for doing more. it doesn't reward them for doing a better job, it doesn't reward them for keeping their patients healthy. it rewards them for delivering more care. >> what do the doctors think of the fee for service? did you find out? >> nobody is happy with fee for service. it's an antiquated broken per verse system that nobody is happy with, that is the predominant way in which medicine is reimbursed in our country. you know, we pay for pieces and we get pieces. as they explain in the clip, we pay for individual procedures. we pay for prescribing drugs,
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we pay for pieces. each service that a doctor provides they're paid for. and when you're paid in that system you're incentivized to do more. you're not incentivized to do what's right for the patient. you're incentivized to do more procedures or give more pills. so the problem with that is that you don't really get to the bottom of what's wrong with somebody necessarily. you don't have the time to spend 45 minutes trying to understand what's going on with their heart condition, whether there's other ways of perhaps changing lifestyle or are there other things. it's much easier to say we'll go into the cardiac catsdz lab and put a stint in. >> how did you get to the cleveland clinic and dr. leslie chow? and there's another doctor here and how did you find yvonne osborne? >> so we were reading the "new
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york times" and there's an article about a man, a doctor outside of washington, d.c. who had -- would basically be arrained for putting in way too many stints. and this article sort of explained again overtreatment and what one of the doctors quoted was the leading expert the head of cardiology at the cleveland clinic. so we gave him a call and asked him to be in our film and he agreed. and it's sort of through him that we learned more about the cleveland clinic. as really a model for health care. and in speaking with them we met dr. chow and yvonne osborne was one of dr. chow's patients. >> here's some more with yvonne osborne to continue that part of the story. >> how are you? >> i am great.
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>> look. >> i have lost since last year 21 pounds. >> oh, my god. >> yvonne came to see me when she was sort of at her wit's end. she had buy pass surgery at an early age. 27 catheter and well over 7 stints. this is just an unbelievable amount of stints and cardiac catsdzes. >> i'm sorry it's going to get pretty tight. >> i can't tell you how shocked we were when we saw her the first time. because here was a young woman whose diabetes was not well controlled. her cholesterol was never well controlled. and her high blood pressure was never well controlled. if someone had talked to her i think someone had teased out her chest pain and shortness of breath i think many would not have been necessary. >> 27 catheterizations. how did you find that to be the case? >> that's definitely an extreme case. but it's not that extreme.
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people often -- so many people have stints that don't need them. in fact, 97% literally of stints don't actually -- aren't helpful or aren't useful. >> why do they do it then? >> because that's what they're taught to do. that's what -- it's easier to put in a stint than to spend 45 minutes talking to a patient than spending time getting them to change their lifestyle or putting them in cardiac rehab. and frankly it pays more. as we see it pays -- you get paid $1500 or you get paid $15 to spend 45 muppets. what would you do? >> how often did you get the feeling that hospitals or doctors or doctors groups actually wanted to generate more money instead of take care of patients? >> i don't think anyone goes in
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-- i'm not a cynic. i don't think people go into medicine to hurt people. i don't think people go into medicine to make money off of people. but we've set up a system that allows doctors to profit off of sickness, that allows doctors to profit off of doing these procedures. and if those are the incentives that you're given, then what are you going to do? as dr. nissen says in our film to a man with the hammer everything looks like a nail. and that really holds true when it comes to this fee for service model that they're paid that way, they're taught that way. that's the culture and that's what they do. >> the woman yvonne osborne. what were your arrangements with her and how long did it take you to find her as the one you were going to video? >> took a couple weeks. for us casting is incredibly important. we never like to film people
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who -- and leave them on the cutting room floor as much as possible. when we film someone we want to know we're going to use them. so we're very judicious in finding who we want to film and speaking to them at length beforehand. and so it was a several week long process in finding her and ultimately filming her. >> who is dr. leslie cho? >> he is the head of cardiology for the women's clinic at the cleveland clinic. >> and she talks about the fact that she gets $15 to talk to somebody for 45 minutes and $1500 to do the catheterization. >> so she's saying that in traditional medicine that's what happened. at the cleveland clinic they're paid on salary so she doesn't get paid any more to do more. she doesn't do any more to give more care. she gets paid a flat salary and she gets incentivized to do a
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better job. >> but i've never seen a case where it's only $15 for a visit. >> it's how much the doctors themselves get paid. >> not the hospital. >> not the hospital. >> you've got another doctor that you feature, a young woman with a small child at least one child we saw and the documentary dr. aaron martin. where is she? >> she's based in oregon. >> and why did you go to her? >> i think dr. martin for us really represent it had frustration of doctors. i think we as americans every day americans who aren't in the medical field i think most americans aren't happy with health care. with the health care that they get. with the time that they get with their doctors. but what they don't -- what i didn't realize was how unhappy doctors are. 50% literally 50% of doctors would get out of medicine if
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they could. >> get out? >> yeah. there's a study that just found that 50% would get out of medicine if they could. so what dr. martin really represents to us is not only the frustration of doctors but the frustration of primary care doctors which really should be the basis of health care. we have this obsession with specialists. specialists get paid more. doctors are more incentivized to go into specialty care and we have a dirtsdz of primary care physicians. primary care is really the basis of health care. that's how we have preventive care. how we move from having a disease care system to a true health care system. >> she is in a community health clinic. what was the situation there? who paid for that health clinic? do you know? >> that's sort of a government-run clinic for the most part. they mostly get paid by the state and through medicare and medicaid. >> let's introduce everybody to
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dr. martin. >> sure. >> instead of basing thingses on outcomes on how good of a job we're doing, the government sets the reimbursement completely on the number of patients that we see. it doesn't matter how complicated they are, how much time that we spend on them. it's just a number one two three four five. you have to play this game with what does this patient need and how much time am i willing to spend with them because the administration is telling you you need to spend more patients. we're in the red. and if you try to buck the system, someone says what can we do to get your productivity up? i'm not interested in getting my productivity up. i'm interested in helping patients. >> what happened to her? >> she as you can kind of see in that clip was not happy with where she was. she was not happy with the revolving door patients. she was not happy with being forced to put band aid fixes on
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much deeper problems. she really -- she was handcuffed by the system. she couldn't practice the medicine that she was taught to practice. she couldn't help these people. she wasn't given the time. she was forced to see so many patients. and so she was just so frustrated that she ended up leaving. so that was actually her last day at that clinic. and we follow her over many months as she's sort of seeks out a different clinic that perhaps will allow her to succeed in a more meaningful way. >> did you know when you went to oregon and voopted her that she was leaving? >> we knew that she was leaving. >> where did she end up? >> she ended up going to a fellowship with dr. andrew wile who is a big proponent of preventive medicine. and what he has done is he really thinks that there's a gap in medical education that
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most medical schools only spend four hours on nutrition. if you look at heart disease, i don't know the exact number but there's a huge percentage of heart disease is based on nutrition and lifestyle choices and doctors are -- and heart disease is the number one killer in america. and doctors are taught four hours of nutrition. so i think what he is trying to do is he basically brings in doctors from all over the country and sort of reteaches them in a way a much more holistic look at the body, teaches them preventive medicine, teaches them nutrition and other things. and these are not just primary care doctors. these are specialists as well that are coming from all over the country so she goes to this fellowship program where she's sort of reinvigorated by it and ends up finalding another clinic to go practice. >> so when the doctor sees dr. andrew wile, university of
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arizona, very well known book writer and dean ornish in this, what message is that? who is going to say, ah, i now know where they're coming from? >> i think a lot of people view dr. wile and dr. ornish sort of as fringe doctors who advocate for alternative medicine. i think that's an unfair viewpoint. i think first they're both incredibly smart, incredibly passionate about fixing our health care system. and they both strongly strongly believe that we need to move away from this system to a much more preventive-based health care system. you know, dr. wile himself is dedicating himself to education and through education you can
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really change the culture of medicine. dr. ornish has really used science to show that lifestyle can actually reverse heart disease. i mean, it's amazing what he has done recently. he's shown that you can shorten your -- tell meers are the ends of your chromosomes. and when you're stressed your telemeers get lessened. when you don't eat we will when you don't exercise they get lessened. and you're much more if you increas your lifestyle, if you exercise more, if you eat right, if you destress, you can actually lengthen your telemeers and protect yourself against disease. >> another name we're going to see this gentleman is somewhat known in this town because he was a recess appointment to run medicaid and medicare dr. burwick.
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the republicans blocked him but people would write that the republicans really liked him as well as the democrats but because of the situation here in town. what led to your decision to use dr. berwick as one of your chief spokesmen? very two things one he is one of the leading minds in health care. and i think he's one of the few people that can actually fix our system. but the real reason why we were led to him is that he wrote an essay which was previously a speech he gave called escape fire lessens for the future of health care. so for about a year-1/2 our film was called a tale of two systems. which is pretty much the most boring film title of all times. and we were literally scratching our heads, couldn't figure out what the call the film and someone sent us this essay called the escape fire.
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and instantly when we read that we knew that's what we can'ted to call the film. we knew that's how we wanted to start our film. so we sought him out to be interviewed for the film. ultimately ended up being a sort of stage-like character of our film coming in and out as one of our sort of chorus of experts that we interwe've through the film. >> we see -- let's watch. >> we spend a spectacular amount of money on health care. just here are the numbers. $2.7 trillion per year. the average per capita cost of health care in the developed world is about $3,000. in the united states it's about $8,000 annually. we spend one heck of a lot of
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money. >> the health care system isn't affordable any more. who pays for that? where does that money come from? this is all coming out of our pockets. it's your money. >> the really astonishing part about about the fact that we spend more is that we have worse health outcomes. >> if you need real serious technology today like a very complex surgery you're lucky to be in this country. rescue care is second to none. as an overall system? no. we're not anywhere near the best in the world. look at our results. our lifespan isn't even in the top 20. >> we have a disease care system and we have a very profitable disease care system. and the disease care system actually -- i mean, if it really was honest with itself it doesn't want you to die and it doesn't want you to get well. it just wants you to keep coming back for your care of your chronic disease.
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>> the post shows that a lot of americans really think we're the best in the world. we're the -- we have the best in the world. who is going to be the most unhappy with this film? >> people always asks us who are the villains? >> i didn't ask you that. i wanted to know who you think will be unhappy though. who will sit out and say that point of view is just ba loneie? >> i think the status quo will be unhappy with the film. the status quo is really powerful. andy wile says in our film there's rivers of money flowing to very few pockets and the owners of those pockets don't want to see anything change. and the owners of those pockets are the big insurers, the pharmaceutical industry, the medical device industry. and they're making a lot of money off the care system, off this disease care system that we have. and they don't want to see anything change.
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but i think what we see in that clip is that we spend twice as much as any other developed country in the world but we're at or near the bottom on almost every metric of health care, 50th in lifespan. infant mortality. we're i think in the 20's. literally almost every metric of health we're at or near the bottom. so clearly we're spending more but getting way less. and this has to change. >> one of those that was obviously and visibly critical of the insurance companies was the former insurance company executive by the name of wend el potter who is he? >> wendell potter was a former executive at signature in a. -- cigna. who visited a place called remote area medical was started by a tv personality from britain. they would send airplanes in to third world countries to
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provide health care. they realized that there's places in the u.s. that weren't getting -- that needed equally need that had type of care. and so he literally flies in these jumbo jets and provides health care at fair grounds, you know, nascar grounds, and when wendell potter went to go visit one of these remote area medical missions he saw thousands and thousands of uninsured people who were standing in line to get health care at animal stalls and barnes. and he had this crisis of conscience and he realized that what he was doing he was denying access to care. >> he was with cigna? >> yes. and he realized he couldn't continue. >> did he speak out before or after he left the company? >> he stayed in the company for a couple of months and then just couldn't keep looking himself in the mirror and decided to resign. >> how does he make his money now?
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>> he wrote a book about his experience and he speaks and lectures and -- yeah. and writes. >> have the insurance companies done anything to try to stop him? >> i think -- he doesn't like being called a whistleblower. i think it's hard for them to try to stop him because he's a really grounded -- a lot of whistleblowers are extreme and polarizing. he's really well liked by everyone. even people in the industry. so it's hard to -- he doesn't have too many enemies. i'm sure certain people in the insurance industry don't like him but he's not -- he's sort of unveiling something that people sort of already knew but really speaking the truth about it. >> here's wendell potter. >> there's the assumption that people who run government are elected officials. are members of congress. but it's not true in many
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cases. the power lies with corporations and corporate interests and the lobbyists that they buy. i was almost as surprised as anybody to see the report that is i was the most frequent visitor to the white house during the health reform debate. it was important to keep expressing the hospital's position. it's an expensive world to live in, in terms of getting your voice heard in d.c. but that's the whole function of advocacy. >> how powerful are lobbyists in the health care system? infinitely. >> why did the head of the american hospital association talk to you? >> they wanted to give their
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per sective and we want it had perspective of lobbyists. i don't think he as bad guy at all. i think he's just doing his job. his job is to advocate on behalf of hospitals and that's the way our system is set up. >> shannon brown i laughed about the money thing. $1.1 billion. what did the health care industry get for that $1.1 billion? >> specifically the insurance industry got a bill that didn't have a public option and got a bill that was essentially giving them 30 million more customers. so i think the real winners of the health care bill were the insurance industry. that got many, many more customers. and people don't really think about it that way but that's sort of what happened. >> how much money a year do we spend on pharmaceuticals? >> $300 billion. >> and that $1.1 billion wasn't
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all pharmaceuticals. >> no. it was a number of different health care lobbyists. >> what did the hospitals get out of the bill? >> it's unclear what the -- what exactly the hospitals won from the bill. i mean, i think one of the things that's beneficial coming out of the bill for sure is that there are many demonstration projects in which they're trying to examine different forms of payment where hospitals instead of getting paid for this fee or service, instead of getting paid for doing more they're given a lump sum of money and say you have to take care of these people and touf be more judicious with how you're paying for them. so it's much more of an emphasis on quality versus quantity. and remains to be seen if that's going to work. >> you say you're not cynical but you went through the whole
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alzheimer's' discussion for hbo. now you've been through this documentary on health care. if you watch your documentary, the pharmaceuticals get knocked. the government gets knocked by the fact that they determined that as we saw the doctors have to see so many patients a day in order to make the money and all. are we better off today than we were before the health care bill was passed? how did you come out of this? >> i think -- with our film we really tried to be agnostic politically. so many of these documentaries you sort of walk out of them feeling depressed and hopeless. and we really did not want to make that type of film. from day one we wanted to make a film that highlighted not just problems but solutions. but we also wanted to make a film that wasn't partisan that wasn't tied to a piece of
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legislation. that essentially would allow a sane and meaningful conversation. that's the whole goal of the film is to change our country's views of health and healing and to bring all stake holders to the table. >> here's the c.e.o. of safeway. before we show that why did you talk to him? >> safeway was really a model that both sides again speaking about that both sides sort of lauded as how the private sector can be part of the solution. >> let's watch steve bird. >> one company has figured out how to lower health care costs by more than 40%. >> it's an idea that's received national attention. >> following the example of places like safeway. >> the safeway super market chain looked for a way to rein in spiraling premiums and hit on what seems to be a win-win solution. >> in 2005, we had a $1 billion health care bill rising at the
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rate of $100 million per year. >> these are the cost of all of our drugs in order. so diabetics. you can see how many. >> what we discovered was that 70% of health care costs were drive bin people's bavers. >> i was over 200 pounds. i had my pizza, my comics, dvds and that was my weekend. >> you realize one day, i haven't worked out, i haven't exercised and you get busy and it's the last thing that you're really concerned about. >> i was chronically coming down with colds and i knew that there was a history of cancer in my family, diabetes. heart disease. i was a walking dead man. >> i was a business guy. i thought if we could influence behavior of our 200,000 person workforce we could have a material effect on health care costs. the easiest starting point was
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in the 30,000 nonunion workforce. and i believed that within four years all of our employees will get this kind of health care plan. >> $1 billion health care bill going up at $100 million per year. one of the messages it seems like you put through on this documentary is stop eating so much and exercise. >> i mean, 75% of health care costs, three quarters of health care costs go to preventible diseases. heart disease, sorme forms of cancer, deeshts. and so we really as a society need to figure out how to become more healthy. we need to invent vise people to do so, give them resources to do so, we need to stop subsidizing the wrong foods. i mean, it's a multifact torle problem. americans also lazy people you know. we want -- part of i think what we see in the film and that we all experience in our daily lives. if we don't go to the doctor
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and we don't get a pill to fix something we're unhappy. so i think one of the messages that we really hope comes across is that we do have this amazing power to heal, that we do have ownership over our own health. sure some people have genetic predispositions and because of socio economic status don't have the same resources but within all of us we have the capacity for healing. >> how much can you tell us about how much this costs you to do? >> the film? >> mm-hmm. >> i don't know. i don't feel comfortable. >> who funded it? >> we had one investor. but the majority of the funding came from grants, from foundations. and from individuals all across the country who believed in what we were doing. >> how can somebody get this if they want it? >> so it is -- we just released it in theaters across the country. it's also available on i tunes and video on demand.
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>> do you want to make money with this? >> i think to us -- no. i mean, of course i need to make money to live and to put cheerios on the table. but -- and to get by. but for us this film is much more than just a film. it's much more than just a commercial project. we really hope that this film can be used for social good and we're seeing that happen already. i mean, two weeks ago we screened at over 62 medical schools across the country all in one night. and i was at johns hopkins just north of here and just to see the energy for change. i mean, i think there's really this powerful movement out there that people want to change the system, that people want to fix this problem. and then a week later we screened at the pentagon hosted by the u.s. arm surgeon general. she said this is going to propel us to change how we practice medicine in the miltrifment that's powerful
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stuff. and what i'm most optimistic about is that we -- i don't know if we can wait for change to happen in washington. i don't know if we can wait for national change. what i'm most optimistic about is change happening at a local level. community by community, hospital by hospital, clinic by clinic. >> final clip for our discussion. dr. martin back and dr. nissen from the cleveland clinic. >> the commercials on television why we need to wait we can just take a pill right now. >> when i watched the networks half are for pharmaceutical agents. that isn't true in canada, not true in united kingdom france or germany. the only other country new zealand. where you can advertise prescription drugs. what does that do? well it drives demand. the ads always and with the same phrase. ask your doctor.
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and people do. and doctors wanting to please their patients will often prescription it. >> do you know when this started having pharmaceutical ads on television? >> to be honest, i don't know. i think it was in the 70s but i'm not exactly sure. but we're the only other country other than new zealand that's allowed to do this. >> why? and why new zealand? that's a good question. i don't know why. and why are we allowed to? who knows. i mean, it's really -- i mean, restless leg syndrome. some of these agencies have created diseases that we've built drugs around and people are making millions of dollars off them. >> did you look into why we see these ads and they often appear on the evening news shows where they will advertise something and say your left arm might fall off your right here might go away and they go on and on
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and on of what the side effects are. why do they have to do that and why do they do it? >> they're legally obligated to list the side effects. it was a law that was passed that forced them to list the side effects. we actually had a sequence in the film of tragic comedy listing sort of all the side effects your head will fall off your arm will fall off your private partless fall off. it's crazy that these things actually happen to people and that we're giving drugs to people that have these side effects. in the film we see the story of avandia, a drug that was used for diabetes and it ended up killing between 50 and 200,000 people because the company really sat on the evidence and
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hid the fact that this was causing heart attacks in a subset of patients. >> what's next for you? >> i don't know. i don't have any plans for another film. i'm really dedicated to getting this film out there. i really believe in this message and i plan on traveling around the country with this film to -- right now we're in sort of the traditional release in theaters and demand on i tunes and but i want to continue to take the film into medical schools, into businesses. we're planning on doing some with the v.a. and i want to continue to work with the military. to really make sure that this film can have an impact. >> for those that like documentary film making, what's the big lesson you learned in doing this particular film that you'll never do again? >> boy. i don't know if i'm ever going
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to take on such a big topic like this i think one of the biggest hurdles for us was twofold. one, health care when you scratch beneath the surface, it's a pretty boring wonky subject. so we really from day one had to figure out how to make it interesting. and also just such a complex topic. presidents since teddy roosevelt have been trying to fix this problem. so to make it digestable for audiences, it took us three and a half years to make this film. so i think what i've learned personally for myself, for my next film i want it to be much more character driven, following one person or one institution and having that say a larger truth. rfer just to kind of wrap up. born in d.c., grew up in connecticut, went to dartmouth, did a whole project traveling across the country. the name is what again sf >> our time. >> and did the also mers
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project sfliffers one of the producers on that came out in 2009. >> and this documentary is called escape fire. the fight to rescue american health care. our guest has been matthew hineman and we thank you. >> thank you very much. >> thank you very much. >>
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